Adopted children and their parents face unique emotional challenges. Being prepared to tackle these issues can mean the difference between a healthy or a hurtful family life.

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In April 2010, like millions of others across the country, I was shocked and dismayed to hear the story of the Tennessee mom who placed her 7-year-old son alone on a plane to Russia, the country from which she'd adopted him the previous September. In a note to Russian authorities, the mom, Torry Hansen, said she was sending the boy, Justin, back to the country of his birth because he was “violent and has severe psychopathic issues." Hansen also claimed she was taking the drastic step of returning her son because she was lied to during the adoption process regarding Justin's emotional health.

This case hit home: Like Hansen, I am the parent of an internationally adopted child. (Two, in fact.) And while I could never imagine making the decision she did (threatening to send my kids to military school, yes; threatening to send them back to China — never), her case raised several questions in my mind: What kind of preparation did Hansen have before adopting? Was she aware of the emotional issues common to children raised in institutional settings, like orphanages? Did she know that help was available to her to head off such a spectacular and terribly hurtful parenting failure?

To get one thing straight right away, very few international adoptions (or adoptions of any kind) in America end up like Hansen's. This may seem obvious, but it bears pointing out because media coverage of international adoption is largely limited to scandals like Hansen's and coverage of celebrity adoptions. "The majority of adopted youth are functioning within the normal range, including those who came from adverse situations, and well over 90 percent of parents in every type of adoption are satisfied with their adoptions," notes "Keeping the Promise: The Critical Need for Post-Adoption Services to Enable Children and Families to Succeed," an extensive October 2010 report from the Evan B. Donaldson Adoption Institute." And we're talking about a whole lot of kids doing pretty much fine: According to the 2007 National Survey of Children's Health and the 2007 National Survey of Adoptive Parents, there were 444,000 internationally adopted kids living in the United States that year.

However, no matter how you come to it – and to take nothing away from the Peace Corps — parenting is without doubt the toughest job you’ll ever love. And adoption raises some uniquely complex issues in the area of mental and emotional health — issues that if they're ignored can lead to disastrous consequences.

Emotional Health and the Adopted Child

In January 2002, my wife Deb and I began the journey to adopting our daughter, who would be born in a rural part of China's Hunan province in October that year. Adopting internationally requires completing a mountain of paperwork for both the United States and foreign authorities, standing in endless lines at numerous government offices to be fingerprinted (providing proof that you're not an axe murderer or sex offender), submitting to a home study in which nearly every aspect of your life is examined by a social worker, and testing the limits of your patience as you wait for workers in yet another bureaucratic office thousands of miles away to match you with your child.

But that’s only the beginning. Some adoption agencies, including the one my wife and I used, insist that preparing adoptive parents for their children’s potential physical and emotional health issues — as well as the challenges parents may face personally throughout their family’s journey — is of fundamental importance in every adoption process.

Our agency was adamant that we understood the challenges inherent in adopting an orphan from another country. As the Donaldson Institute's "Keeping the Promise" report says: "Most adopted children, because they suffered early deprivation or maltreatment, come to their new families with elevated risks for developmental, physical, psychological, emotional, or behavioral challenges." In highlighting these issues, our agency’s goal wasn't to scare us, some sort of weeding out process of those who couldn't face the potentially hard road ahead, it was to wipe away any delusions we might have had that just because we'd made the decision to open our heart and home to an orphaned child that the child wouldn't come carrying significant emotional and/or physical baggage.

As numerous studies show, adopted children are at greater risk for a variety of disorders, including ADD/ADHD, oppositional defiant disorder, as well as attachment and sensory-integration issues, not to mention language delays and a variety of physical delays. These issues stem from living in orphanages or other institutions, as well as from the effects of chronic neglect, deprivation, poor prenatal nutrition, and prenatal exposure to alcohol or drugs.

The social workers from our agency provided us with stacks of articles to read on early childhood development risks among orphaned children. In a group made up of fellow couples preparing to adopt from China, we aired our deepest concerns. We also heard talks from experts about services available to help us upon our return home with our young children. I honestly believe we could not have been better prepared for any issues we'd end up facing. It is exactly this sort of preparation that I wonder if Torry Hansen was offered.

Getting the Help Parents and Kids Need

Even with this intense preparation, however, parenting is rarely smooth sailing – and it only gets more complicated when you throw adoption into the mix, says Dr. Amanda Baden, assistant professor of psychology at Montclair State University in New Jersey, and a clinical psychologist specializing in adoption issues. And what often complicates matters even more, Dr. Baden says, is that when things get tough too many parents focus only on their child’s problems. “A lot of people focus on the child being unprepared, or having a lot of psychological or emotional issues,” Baden says. “But they often don’t think of what problems adoptive parents go into these relationships with.”

Baden points out that very little research looks at adoptive parents’ psychological issues, and how those issues influence their responses to parenting challenges. “I’ve certainly seen adoptive parents who say, ‘My child has attachment problems.’ And then working with the parents I can see that they, too, have attachment problems,” she says. “So it’s kind of hard to say that all of the problems started on the child’s end, because the parent has a long history of attachment and relationship issues.”

And when parents with emotional issues run up against children with emotional issues, everyone can suffer. “Kids who were raised for the first year of their life in an institution where no one really picked them up, or carried or cuddled them in any way, can be majorly impacted by that,” Baden says. “Just as adoptive parents who are attempting to undo years of emotional issues stemming from their own families bring a lot of complications. When these kinds of forces come together it can be not such a great recipe.”

The good news, however, is that this recipe doesn’t have to equal disaster. As cited above, most American adoptive families are satisfied with their adoptions. But that doesn’t mean it didn’t take a lot of work to get there, or that there isn’t still room for improvement. The key to success is recognizing the challenges and being prepared to deal with them. “You have to know that you really want to parent a child by adoption,” Baden says. “And that means there could be complications, there could be challenges along the way, and that you’re ready to do it.”

Being prepared, Baden notes, means having a variety of different services at the ready to help you out, from physicians who understand international adoption medicine to therapists who can address everything from speech and language delays to occupational issues. But again, preparation shouldn’t begin and end with the adopted child. “There are probably issues that you as a parent might need to explore,” such as your own emotional weak spots, as well as coping with race and ethnicity in a blended family, Baden says. “So having a psychotherapist who is truly skilled and trained in working with adoption is another important part.”

Following are online resources with more information about international and domestic adoption, as well as postadoption services for families:

Postadoption Services: U.S. Children's Bureau
This web page is packed with basic information about postadoption services. It details the common postadoption issues families encounter and the types of postadoption services out there, with advice on how to access those services.

U.S. State Department Bureau of Consular Affairs Office of Children's Issues
The State Department’s website features all of the U.S. legal requirements concerning international adoptions, ranging from criteria for adoption agency accreditation to the visa process required to bring an internationally adopted child home to the United States from abroad. It also has detailed information on each foreign country’s international adoption requirements.

Evan B. Dondaldson Adoption Institute
This nonprofit is the premier research, policy, and education organization in the field of adoption studies. Donaldson's research focuses on domestic as well as international adoption, and the institute’s work is available for download at its website.

AdoptUSKids
A service of the United States Children’s Bureau, AdoptUSKids has a two-fold mission: “to raise public awareness about the need for foster and adoptive families for children in the public child welfare system; and to assist U.S. States, Territories, and Tribes to recruit and retain foster and adoptive families and connect them with children.” The site features photo listings of children waiting for adoption.

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